Change in Palliative Performance Scale (PPS) Predicts Survival in Patients with Terminal Cancer.
10.14475/kjhpc.2017.20.4.235
- Author:
Jee Hye OH
1
;
Yong Joo LEE
;
Min Seok SEO
;
Jo Hi YOON
;
Chul Min KIM
;
Chung KANG
Author Information
1. Department of Family Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. sharp1003@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Palliative care;
Hospice care;
Prognosis;
Survival
- MeSH:
Cohort Studies;
Hospice Care;
Humans;
Inpatients;
Palliative Care;
Prognosis;
Prospective Studies
- From:Korean Journal of Hospice and Palliative Care
2017;20(4):235-241
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The Palliative Performance Scale (PPS) is a widely used prognostic tool in patients with advanced cancer. This study examines the association between changes in PPS score and survival in patients with advanced cancer. METHODS: We identified a cohort of 606 inpatients who died at a Korean university hospital's hospice/palliative care center. For each patient, the PPS score was measured twice according to a standard procedure: 1) upon admission, and 2) three days after admission (D3). “Change on D3” was defined as a difference between initial PPS and PPS on D3. We used a Cox regression modeling approach to explore the association between this score change and survival. RESULTS: The changes in scores were associated with survival. A score change of >30% yielded a hazard ratio for death of 2.66 (95% CI 2.19~3.22), compared to a score change of ≤30%. PPS of ≤30 on D3 also independently predicted survival, with a hazard ratio of 1.67 (95% CI 1.38~2.02) compared to PPS of >30. CONCLUSION: A change of over 30% in PPS appears to predict survival in hospitalized patients with terminal cancer, even after adjustment for confounders. Changes in PPS may be a more sensitive indicator of impending death than a single PPS measured on the day of admission in terminal cancer patients. Further prospective study is needed to examine this important finding in other populations.
